Alfonso Fiorelli1, Fausto Ferraro2, Elisabetta Frongillo3, Pierluigi Fusco2, Matteo Pierdiluca3, Francesca Nagar2, Angela Iuorio2, Mario Santini3. 1. Thoracic Surgery Unit, Seconda Università degli Studi di Napoli, Piazza Miraglia 3, 80100, Naples, Italy. alfonso.fiorelli@unicampania.it. 2. Anesthesiology and Intensive Care Unit, Seconda Università degli Studi di Napoli, Naples, Italy. 3. Thoracic Surgery Unit, Seconda Università degli Studi di Napoli, Piazza Miraglia 3, 80100, Naples, Italy.
Abstract
OBJECTIVE: We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model. METHODS: The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model. The participants were asked to perform PDT in three different sessions to improve their dexterity. The primary endpoint was the reduction of complications seen during the different sessions of the training course. The secondary endpoint was the satisfaction of the participants as assessed by an anonymous survey. RESULTS: Thirty-seven residents in anesthesiology and 7 in thoracic surgery in the first 2 years of their training and without any confidence with percutaneous tracheostomy participated in the study. Tracheal cuff lesions and impalement of the tracheal tube were the most observed complications, and were concentrated in the early sessions. A significant reduction in complications and operative time was seen during the ongoing sessions of the course. No lesions of the posterior tracheal wall and only a ring fracture occurred during the last session of the course. All participants were satisfied with the course. CONCLUSIONS: Our course seems to confer the technical skills to perform percutaneous tracheostomy to trainees and instill confidence with the procedure. However, the experience acquired on a training course should be evaluated in clinical practice.
OBJECTIVE: We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model. METHODS: The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model. The participants were asked to perform PDT in three different sessions to improve their dexterity. The primary endpoint was the reduction of complications seen during the different sessions of the training course. The secondary endpoint was the satisfaction of the participants as assessed by an anonymous survey. RESULTS: Thirty-seven residents in anesthesiology and 7 in thoracic surgery in the first 2 years of their training and without any confidence with percutaneous tracheostomy participated in the study. Tracheal cuff lesions and impalement of the tracheal tube were the most observed complications, and were concentrated in the early sessions. A significant reduction in complications and operative time was seen during the ongoing sessions of the course. No lesions of the posterior tracheal wall and only a ring fracture occurred during the last session of the course. All participants were satisfied with the course. CONCLUSIONS: Our course seems to confer the technical skills to perform percutaneous tracheostomy to trainees and instill confidence with the procedure. However, the experience acquired on a training course should be evaluated in clinical practice.
Authors: Edoardo Zamponi; Silvio Zanaboni; Carlo Maestrone; Francesco Della Corte; Giuliano Pelosi Journal: Intensive Care Med Date: 2003-04-16 Impact factor: 17.440
Authors: Alfonso Fiorelli; Salvatore Mazzone; Vincenzo Giuseppe Di Crescenzo; Giuseppe Costa; Assunta Del Prete; Giovanni Vicidomini; Adriano Mazzone; Mario Santini Journal: Interact Cardiovasc Thorac Surg Date: 2013-12-09
Authors: A F Fiorelli; F F Ferraro; R M Milione; R S Scarumuzzi; P I Imitazione; L M Marulli; A O Orsini; M S Santini Journal: Anaesth Intensive Care Date: 2016-05 Impact factor: 1.669
Authors: Anthony Cipriano; Melissa L Mao; Heidi H Hon; Daniel Vazquez; Stanislaw P Stawicki; Richard P Sharpe; David C Evans Journal: Int J Crit Illn Inj Sci Date: 2015 Jul-Sep